With Some Hospitals Closed After Hurricane, E.R.’s at Others Overflow

A month after Hurricane Sandy struck New York City, unexpectedly shutting down several hospitals, one Upper East Side medical center had so many more emergency room patients than usual that it was parking them in its lobby.

White and blue plastic screens had been set up between the front door and the elevator banks in the East 68th Street building of that hospital, NewYork-Presbyterian/Weill Cornell. The screens shielded 10 gurneys and an improvised nursing station from the view of people obliviously walking in and out of the soaring, light-filled atrium.

“It’s like a World War II ward,” Teri Daniels, who had been waiting a day and a half with a relative who needed to be admitted, said last week.

Since the storm, a number of New York City hospitals have been scrambling to deal with a sharp increase in patients, forcing them to add shifts of doctors and nurses on overtime, to convert offices and lobbies to use for patients’ care, and even, in one case, to go to a local furniture store to buy extra beds.

At Beth Israel Medical Center, 11 blocks south of the Bellevue Hospital Center emergency room, which was shuttered because of storm damage, the average number of visits to the E.R. per day has risen to record levels. Visits have increased by 24 percent this November compared with last, and the numbers show no sign of dropping. Hospital admissions have risen 12 percent compared with last November.

Most of the rise in volume is from patients who had never been to Beth Israel before. An emergency room doctor at the hospital described treating one patient who said he had been born at Bellevue and had never before gone anywhere else.

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Maimonides Medical Center in Brooklyn had 1,100 more emergency patients last month than in November 2011; the increase was mostly attributed to a hospital shut by the storm.Credit
Benjamin Norman for The New York Times

Emergency room visits have gone up 25 percent at NewYork-Presybterian/Weill Cornell, which in Bellevue’s absence is the closest high-level trauma center — treating stab wounds, gun wounds, people hit by cars and the like — in Manhattan from 68th Street south. Stretchers holding patients have been lined up like train cars around the nursing station and double-parked in front of stretcher bays.

In Brooklyn, some patients in Maimonides Medical Center’s emergency room who need to be admitted are waiting two or three days for a bed upstairs, instead of four or five hours. Almost every one of the additional 1,100 emergency patients this November compared with last November came from four ZIP codes affected by the storm and served by Coney Island Hospital, a public hospital that was closed because of storm damage.

The number of psychiatric emergency patients from those same ZIP codes has tripled, in a surge that began three days before the hurricane, perhaps fueled by anxiety, as well as by displacement from flooded adult homes or programs at Coney Island Hospital, doctors said.

The Maimonides psychiatric emergency room bought five captain’s beds — which do not have railings that can be used for suicide attempts — at a local furniture store, to accommodate extra patients. The regular emergency room had to buy 27 new stretchers after the hurricane, “and we probably need a few more,” the department’s chief, Dr. John Marshall, said.

The emergency room and inpatient operations of four hospitals remain closed because of flooding and storm damage. Besides Bellevue and Coney Island, NYU Langone Medical Center and the VA New York Harbor Healthcare System, both near Bellevue on the East Side of Manhattan, are closed.

While the surge in traffic to other hospitals has been a burden, it has also been a boon, bringing more revenue.

On the Upper East Side, the storm has helped Lenox Hill Hospital, which has a history of financial problems. It took two or three wards that had been turned into offices and converted them back to space for patients. Emergency room visits are up 10 percent, and surgery has been expanded to seven days a week from five.

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Angel Perez in a makeshift emergency room last week at NewYork-Presbyterian/Weill Cornell, where emergency visits have increased 25 percent.Credit
Michael Appleton for The New York Times

“We usually operate at slightly over 300 beds, and now we’re at well over 550,” Carleigh Gustafson, director of emergency nursing, said.

Conversely, administrators at the shuttered hospitals, especially NYU Langone, a major teaching center, worry that their patients and doctors are being raided, with some never to return.

NYU’s salaried doctors are being paid through January, on the condition that they do not take another job. But at the same time, they need a place to practice, so NYU administrators have been arranging for them to work as far away as New Jersey until the hospital reopens. Lenox Hill alone has taken on close to 300 NYU doctors, about 600 nurses, and about 150 doctors in training, fellows and medical students.

Obstetricians and surgeons from the closed hospitals have been particularly disadvantaged, since they are dependent on hospitals to treat their patients. Many displaced surgeons have been reduced to treating only the most desperately ill, and operating on nights and weekends, when hospitals tend to be least well staffed.

“I think there’s no question that a lot of people have postponed anything that they can postpone that is elective,” said Dr. Andrew W. Brotman, senior vice president at NYU.

In mid-November, Dr. Michael L. Brodman, chairman of obstetrics at Mount Sinai Medical Center, sent out a memo saying his department had taken on 26 NYU physicians, as well as nurses and residents, but “clearly, that is too much for us to handle long term.”

Since then, 15 of the physicians have gone to New York Downtown Hospital, while Mount Sinai has retained 11 doctors and 26 nurses.

“We are guests in other people’s homes,” Dr. Brotman of NYU said, “and we are guests who have to some degree overstayed their welcome.”

Joanna Walters contributed reporting.

A version of this article appears in print on December 4, 2012, on page A24 of the New York edition with the headline: With Some Hospitals Closed After Hurricane, E.R.’s at Others Overflow. Order Reprints|Today's Paper|Subscribe